1887
Surveillance Open Access
Like 0

Abstract

Background

Unprecedented non-pharmaceutical interventions to control the COVID-19 pandemic also had an effect on other infectious diseases.

Aim

We aimed to determine their impact on transmission and diagnosis of notifiable diseases other than COVID-19 in Bavaria, Germany, in 2020 and 2021.

Methods

We compared weekly cases of 15 notifiable infectious diseases recorded in Bavaria between 1 January 2016 and 31 December 2021 in time series analyses, median age and time-to-diagnosis using Wilcoxon rank sum test and hospitalisation rates using univariable logistic regression during three time periods: pre-pandemic (weeks 1 2016–9 2020), pandemic years 1 (weeks 10–52 2020) and 2 (2021).

Results

Weekly case numbers decreased in pandemic year 1 for all diseases assessed except influenza, Lyme disease and tick-borne encephalitis; markedly for norovirus gastroenteritis (IRR = 0.15; 95% CI: 0.12–0.20) and pertussis (IRR = 0.22; 95% CI: 0.18–0.26). In pandemic year 2, influenza (IRR = 0.04; 95% CI: 0.02–0.09) and pertussis (IRR = 0.11; 95% CI: 0.09–0.14) decreased markedly, but also chickenpox, dengue fever, invasive infection, hepatitis C, legionellosis, noro- and rotavirus gastroenteritis and salmonellosis. For enterohaemorrhagic infections, median age decreased in pandemic years 1 and 2 (4 years, interquartile range (IQR): 1–32 and 3 years, IQR: 1–18 vs 11 years, IQR: 2–42); hospitalisation proportions increased in pandemic year 1 (OR = 1.60; 95% CI: 1.08–2.34).

Conclusion

Reductions for various infectious diseases and changes in case characteristics in 2020 and 2021 indicate reduced transmission of notifiable diseases other than COVID-19 due to interventions and under-detection.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2023.28.41.2300030
2023-10-12
2024-02-28
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2023.28.41.2300030
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/28/41/eurosurv-28-41-3.html?itemId=/content/10.2807/1560-7917.ES.2023.28.41.2300030&mimeType=html&fmt=ahah

References

  1. World Health Organization (WHO). COVID-19 continues to disrupt essential health services in 90% of countries. Geneva: WHO; 2021. Available from: https://www.who.int/news/item/23-04-2021-covid-19-continues-to-disrupt-essential-health-services-in-90-of-countries
  2. World Health Organization (WHO). The impact of the COVID-19 pandemic on noncommunicable disease resources and services: results of a rapid assessment. Geneva: WHO; 2020. Available from: https://www.who.int/publications/i/item/9789240010291
  3. World Health Organization (WHO). Pulse survey on continuity of essential health services during the COVID-19 pandemic: interim report, 27 August 2020 Geneva: WHO; 2020. Available from: https://www.who.int/publications/i/item/WHO-2019-nCoV-EHS_continuity-survey-2020.1
  4. Oh KB, Doherty TM, Vetter V, Bonanni P. Lifting non-pharmaceutical interventions following the COVID-19 pandemic - the quiet before the storm? Expert Rev Vaccines. 2022;21(11):1541-53.  https://doi.org/10.1080/14760584.2022.2117693  PMID: 36039786 
  5. Charles H, Ratna N, Thorn L, Sonubi T, Sun S, Mohammed H, et al. COVID-19 impact on bacterial sexually transmitted infections in England between 1 January 2019 and 31 December 2020. Sex Transm Infect. 2021;98(7):537-8. PMID: 34548415 
  6. Dorward J, Khubone T, Gate K, Ngobese H, Sookrajh Y, Mkhize S, et al. The impact of the COVID-19 lockdown on HIV care in 65 South African primary care clinics: an interrupted time series analysis. Lancet HIV. 2021;8(3):e158-65.  https://doi.org/10.1016/S2352-3018(20)30359-3  PMID: 33549166 
  7. El Moussaoui M, Lambert N, Maes N, Fombellida K, Vaira D, Moutschen M, et al. Impact of the COVID-19 pandemic situation on HIV care in Liège, Belgium. HIV Res Clin Pract. 2021;22(3):63-70. PMID: 34308800 
  8. Guo X, Ma C, Wang L, Zhao N, Liu S, Xu W. The impact of COVID-19 continuous containment and mitigation strategy on the epidemic of vector-borne diseases in China. Parasit Vectors. 2022;15(1):78.  https://doi.org/10.1186/s13071-022-05187-w  PMID: 35248146 
  9. Sulik M, Toczyłowski K, Grygorczuk S. Epidemiology of tick-borne encephalitis in Poland (2010-2019) and the impact of the COVID-19 pandemic on the notified incidence of the disease. Przegl Epidemiol. 2021;75(1):76-85. PMID: 34338473 
  10. Ray LC, Collins JP, Griffin PM, Shah HJ, Boyle MM, Cieslak PR, et al. Decreased incidence of infections caused by pathogens transmitted commonly through food during the COVID-19 pandemic - foodborne diseases active surveillance network, 10 U.S. sites, 2017-2020. MMWR Morb Mortal Wkly Rep. 2021;70(38):1332-6.  https://doi.org/10.15585/mmwr.mm7038a4  PMID: 34555002 
  11. Ullrich A, Schranz M, Rexroth U, Hamouda O, Schaade L, Diercke M, et al. , Robert Koch’s Infectious Disease Surveillance Group. Impact of the COVID-19 pandemic and associated non-pharmaceutical interventions on other notifiable infectious diseases in Germany: An analysis of national surveillance data during week 1-2016 - week 32-2020. Lancet Reg Health Eur. 2021;6:100103.  https://doi.org/10.1016/j.lanepe.2021.100103  PMID: 34557831 
  12. Kitazawa K, Tokuda Y, Koizumi S. Health-care-seeking behaviours of the Japanese lay public during the COVID-19 pandemic: a cross-sectional study. J Prim Health Care. 2021;13(4):351-8.  https://doi.org/10.1071/HC21009  PMID: 34937648 
  13. Brandl C, Zimmermann ME, Günther F, Dietl A, Küchenhoff H, Loss J, et al. Changes in healthcare seeking and lifestyle in old aged individuals during COVID-19 lockdown in Germany: the population-based AugUR study. BMC Geriatr. 2022;22(1):34.  https://doi.org/10.1186/s12877-021-02677-x  PMID: 34998375 
  14. Giezendanner S, Fischer R, Diaz Hernandez L, Zeller A. The use of health care during the SARS-CoV-2 pandemic: repeated cross-sectional survey of the adult Swiss general population. BMC Public Health. 2021;21(1):853.  https://doi.org/10.1186/s12889-021-10854-1  PMID: 33941109 
  15. Jeong HY, Lee EJ, Kang MK, Nam KW, Bae J, Jeon K, et al. Changes in Stroke Patients’ Health-Seeking Behavior by COVID-19 Epidemic Regions: Data from the Korean Stroke Registry. Cerebrovasc Dis. 2022;51(2):169-77.  https://doi.org/10.1159/000519093  PMID: 34592732 
  16. Czeisler , Marynak K, Clarke KEN, Salah Z, Shakya I, Thierry JM, et al. Delay or avoidance of medical care because of COVID-19-related concerns - United States, June 2020. MMWR Morb Mortal Wkly Rep. 2020;69(36):1250-7.  https://doi.org/10.15585/mmwr.mm6936a4  PMID: 32915166 
  17. Robert Koch-Institut (RKI). Wöchentlicher Lagebericht des RKI zur Coronavirus-Krankheit-2019 (COVID-19). 23.12.2021 – Aktualisierter Stand Für Deutschland. [RKI weekly situation report on the coronavirus disease 2019 (COVID-19). 23 Dec 2021 – Updated status for Germany]. Berlin: RKI; 2021. German. Available from: https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Situationsberichte/Wochenbericht/Wochenbericht_2021-12-23.pdf?__blob=publicationFile
  18. Bayerisches Staatsministerium für Gesundheit und Pflege. Zehnte Bayerische Infektionsschutzmaßnahmenverordnung (10. BayIfSMV) vom 8. Dezember 2020. [Tenth Bavarian Infection Protection Measures Ordinance (10th BayIfSMV) of December 8, 2020]. Munich: State Ministry for Health and Care; 2020. German. Available from: https://www.verkuendung-bayern.de/baymbl/2020-711
  19. Bayerisches Staatsministerium für Gesundheit und Pflege. Elfte Bayerische Infektionsschutzmaßnahmenverordnung (11. BayIfSMV) vom 15. Dezember 2020. [Eleventh Bavarian Infection Protection Measures Ordinance (11th BayIfSMV) of December 15, 2020]. Munich: State Ministry for Health and Care; 2020. German. Available from: https://www.verkuendung-bayern.de/files/baymbl/2020/737/baymbl-2020-737.pdf
  20. Bayerisches Staatsministerium für Gesundheit und Pflege. Verordnung zur Änderung der Elften Bayerischen Infektionsschutzmaßnahmenverordnung vom 15. Januar 2021. [Ordinance Amending the Eleventh Bavarian Infection Protection Measures Ordinance of January 15, 2021]. Munich: State Ministry for Health and Care; 2021. German. Available from: https://www.verkuendung-bayern.de/baymbl/2021-34
  21. Bayerisches Staatsministerium für Gesundheit und Pflege. Vierzehnte Bayerische Infektionsschutzmaßnahmenverordnung (14. BayIfSMV) vom 1. September 2021. [Fourteenth Bavarian Infection Protection Measures Ordinance (14th BayIfSMV) of September 1, 2021]. Munich: State Ministry for Health and Care; 2021. German. Available from: https://www.verkuendung-bayern.de/baymbl/2021-615
  22. Bundesministerium der Justiz und für Verbraucherschutz (BMJV). Gesetz zur Verhütung und Bekämpfung von Infektionskrankheiten beim Menschen (Infektionsschutzgesetz – IfSG). [Act for the prevention and control of human infectious diseases (Protection against infection act)]. Berlin: BMJV; 2000. German. Available from: https://www.gesetze-iminternet.de/ifsg/BJNR104510000.html
  23. Tolksdorf K, Loenenbach A, Buda S. Dritte Aktualisierung der „Retrospektiven Phaseneinteilung der COVID-19-Pandemie in Deutschland”. [Third update of the “Retrospective phase classification of the COVID-19 pandemic in Germany]. Epid Bull.2022;38:3-6. German.  https://doi.org/10.25646/10598 
  24. Zeger SL, Irizarry RA, Peng RD. On time series analysis of public health and biomedical data. Working Paper 54. Baltimore: Johns Hopkins University; 2004. Available from: http://biostats.bepress.com/jhubiostat/paper54
  25. Robert Koch-Institut (RKI). Infektionsepidemiologisches Jahrbuch meldepflichtiger Krankheiten für 2020. [Epidemiological yearbook of notifiable infectious diseases for 2020]. Berlin: RKI; 2021. German. Available from: https://www.rki.de/DE/Content/Infekt/Jahrbuch/Jahrbuch_2020.html
  26. Foley DA, Yeoh DK, Minney-Smith CA, Martin AC, Mace AO, Sikazwe CT, et al. The interseasonal resurgence of respiratory syncytial virus in Australian children following the reduction of coronavirus disease 2019-related public health measures. Clin Infect Dis. 2021;73(9):e2829-30.  https://doi.org/10.1093/cid/ciaa1906  PMID: 33594407 
  27. Maison N, Peck A, Illi S, Meyer-Buehn M, von Mutius E, Hübner J, et al. The rising of old foes: impact of lockdown periods on "non-SARS-CoV-2" viral respiratory and gastrointestinal infections. Infection. 2022;50(2):519-24.  https://doi.org/10.1007/s15010-022-01756-4  PMID: 35076891 
  28. Yasmin F, Ali SH, Ullah I. Norovirus outbreak amid COVID-19 in the United Kingdom; priorities for achieving control. J Med Virol. 2022;94(3):1232-5.  https://doi.org/10.1002/jmv.27426  PMID: 34713915 
  29. Robert Koch-Institut (RKI). Infektionsepidemiologisches Jahrbuch meldepflichtiger Krankheiten für 2019. [Epidemiological yearbook of notifiable infectious diseases for 2019]. Berlin: RKI; 2020. German. Available from: https://www.rki.de/DE/Content/Infekt/Jahrbuch/Jahrbuch_2019.html
  30. Forschungsgemeinschaft Urlaub und Reisen e.V. Reiseanalyse 2022 - Erste augewählte Ergebnisse der 52. Reiseanalyse. [Travel analysis 2022 - First selected results of the 52nd travel analysis]. Kiel: Forschungsgemeinschaft Urlaub und Reisen e.V.; 2022. Available from: https://reiseanalyse.de/downloadbereich/erste-ergebnisse
  31. Robert Koch-Institut (RKI). RKI-Ratgeber. EHEC-Erkrankung. [RKI guide. EHEC disease]. Berlin: RKI; 2011. German. Available from: https://www.rki.de/DE/Content/Infekt/EpidBull/Merkblaetter/Ratgeber_EHEC.html#doc2374530bodyText4
  32. Robert Koch-Institut (RKI). RKI-Ratgeber. Campylobacter-Enteritis. [RKI guide. Campylobacter-enteritis]. Berlin: RKI; 2018. German. Available from: https://www.rki.de/DE/Content/Infekt/EpidBull/Merkblaetter/Ratgeber_Campylobacter.html#doc2374558bodyText5
  33. Robert Koch-Institut (RKI). RKI-Ratgeber. Salmonellose. [RKI guide. Salmonellosis]. Berlin: RKI; 2016. German. Available from: https://www.rki.de/DE/Content/Infekt/EpidBull/Merkblaetter/Ratgeber_Salmonellose.html#doc2374560bodyText5
  34. European Food Safety AuthorityEuropean Centre for Disease Prevention and Control. The European Union One Health 2021 Zoonoses Report. EFSA J. 2022;20(12):e07666. PMID: 36524203 
  35. Universität Erfurt (UE), Robert Koch-Institut (RKI), Leibniz-Zentrum für Psychologische Information und Dokumentation (ZPID), Science Media Center (SMC), Bernhard Nocht Institute for Tropical Medicine (BNITM), Yale Institute for Global Health (YIGH). COSMO Covid-19 snapshot monitoring – Risikowahrnehmung. [Risk perception]. Berlin: RKI; 2022. German. Available from: https://projekte.uni-erfurt.de/cosmo2020/web/topic/risiko-emotionen-sorgen/10-risikowahrnehmung/#situative-risikowahrnehmung-expositionsh%C3%A4ufigkeit-und-schutzverhalten-stand-05.10.21
  36. Robert Koch-Institut (RKI). RKI-Ratgeber. Hepatitis B und D. [RKI guide. Hepatitis B and D]. Berlin: RKI; 2016. German. Available from: https://www.rki.de/DE/Content/Infekt/EpidBull/Merkblaetter/Ratgeber_HepatitisB.html#doc2390050bodyText13
  37. Reyniers T, Rotsaert A, Thunissen E, Buffel V, Masquillier C, Van Landeghem E, et al. Reduced sexual contacts with non-steady partners and less PrEP use among MSM in Belgium during the first weeks of the COVID-19 lockdown: results of an online survey. Sex Transm Infect. 2021;97(6):414-9.  https://doi.org/10.1136/sextrans-2020-054756  PMID: 33172917 
  38. Robert Koch-Institut (RKI). RKI-Ratgeber Hepatitis C. [RKI guide. Hepatitis C]. Berlin: RKI; 2018. German. Available from: https://www.rki.de/DE/Content/Infekt/EpidBull/Merkblaetter/Ratgeber_HepatitisC.html;jsessionid=C2417FC875F9A4CFDB108562013708E0.internet122#doc2389942bodyText3
  39. Kondili LA, Buti M, Riveiro-Barciela M, Maticic M, Negro F, Berg T, et al. Impact of the COVID-19 pandemic on hepatitis B and C elimination: An EASL survey. JHEP Rep Innov Hepatol. 2022;4(9):100531.  https://doi.org/10.1016/j.jhepr.2022.100531  PMID: 35967191 
/content/10.2807/1560-7917.ES.2023.28.41.2300030
Loading

Data & Media loading...

Supplementary data

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error